Fatigue, with a prevalence of 75-95%, is one of the most common symptoms in people with multiple sclerosis (Fisk et al 1994, Krupp et al 1995, Flachenecker et al 2008, Giovannoni 2006). The primary objective of the present study is to demonstrate the effectiveness of internet-based strengthening and endurance training (eTraining) in patients with relapsing forms of multiple sclerosis (RR-MS) and clinically isolated syndrome (CIS) in terms of the profile and severity of fatigue as measured by the fatigue scale for motor skills and cognition (FSMC). In addition, the impact of eTraining on cognition, self-awareness, disease processing, depression and quality of life was examined.

Data were collected at baseline (BL), after three (T3), six (T6), nine (T9), and twelve (T12) months. The study population consisted of 83 patients who were randomly assigned to two study groups in BL: immediate group (SG) and delayed group (VG). The SG with 45 subjects started directly after BL with the three-month eTraining. The VG with 38 patients began after a three-month wait with a six-month eTraining.

Total fatigue improved significantly in the SG during the intervention period (M3) (p <0.01). In particular, there was a highly significant (p <0.01) improvement in motor fatigue with a remarkable effect size (ES) of -0.67. Further statistically significant improvements (p <0.05) were found in SG in the areas of depression (ADS), quality of life (FAMS) and self-experienced attention deficit (FEDA). In the time * group interaction, M3 showed a statistical trend (p = 0.09) for greater motor fatigue reduction in SG. Concerning the long-term effect of the eTrainings, the SG showed a stabilization of the fatigue values ​​at a better level. At nine months, fatigue was statistically significantly below the baseline (p = 0.007).

The results of this study indicate that eTraining can positively affect fatigue, and motor fatigue to a greater extent than cognitive fatigue. However, further clinical studies with larger case numbers and clearly defined intervention periods and intervention exercises are needed to prove the positive effect of sport on fatigue final. Concerning the long-term effect of the eTrainings, the SG showed a stabilization of the fatigue values ​​at a better level. At nine months, fatigue was statistically significantly below the baseline (p = 0.007). The results of this study indicate that eTraining can positively affect fatigue, and motor fatigue to a greater extent than cognitive fatigue. However, further clinical studies with larger case numbers and clearly defined intervention periods and intervention exercises are needed to prove the positive effect of sport on fatigue final.